The Relationship between Maternal Employment Status and Pregnancy Outcomes

Association of Pregnant Women's Perinatal Depression with Sociodemographic, Anthropometric and Lifestyle Factors and Perinatal and Postnatal Outcomes: A Cross-Sectional Study

Background: In recent decades, the incidence of depression has gradually increased in the general population globally. Depression is also common during gestation and could result in detrimental gestational complications for both the mother and the fetus. The survey presented aimed to evaluate whether pregnant women's perinatal depression could be associated with socio-demographic, anthropometry and lifestyle factors, and perinatal and postnatal outcomes. Methods: This is a cross-sectional survey conducted on 5314 pregnant women. Socio-demographic and lifestyle factors were recorded by relevant questionnaires via face-to-face interviews. Anthropometric parameters were measured by qualified personnel. Perinatal depressive symptomatology status was evaluated by Beck's Depression Inventory (BDI-II) questionnaire. Results: Depressive symptoms throughout gestation were found in 35.1% of the enrolled women. Perinatal depression was significantly associated with lower educational and economic level, pre-pregnancy regular smoking and reduced levels of Mediterranean diet adherence levels, a higher prevalence of gestational diabetes and preterm birth, as well as a higher incidence of delivering by caesarean section and abnormal childbirth weight. Perinatal depression was also significantly associated with a higher prevalence of maternal postpartum depression and lower prevalence of exclusive breastfeeding practices, as well as with a higher incidence of childhood asthma. Conclusions: Pregnant women's perinatal depression appears to be associated with various socio-demographic, anthropometry, and lifestyle characteristics and with a higher frequency of several adverse pregnancy complications. The present findings emphasize the importance of pregnant women's perinatal mental health, highlighting the need to develop and apply public strategies and policies for psychological counseling and support of future mothers to minimize probable risk factors that may trigger perinatal depression. Novel well-organized, follow-up surveys of enhanced validity are highly recommended to establish more definitive conclusions.

Factors associated with terminated pregnancies in Sri Lanka: A case study of the Sri Lankan Demographic and health survey (DHS) 2016

Pregnancy termination is considered to have adverse effects on women's health and to have created financial, economic, and social problems in their lives. This study aimed to identify factors associated with pregnancy termination in Sri Lanka. The study used 2016 Sri Lanka Demographic and Health Survey (DHS) data of 16,323 ever-married women aged 15-49, who were clustered in selected enumerated areas. A binary logistic random intercept multilevel model was fitted to find the association between pregnancy termination and the predictor variables in this study. The overall pregnancy termination rate among Sri Lankan women was 16.14%. Increasing age of women was found to be associated with increasing odds of pregnancy termination. Women who were overweight or obese had higher odds of pregnancy termination, with 14% and 36%, respectively, compared to women with a normal weight. With increasing parity, the likelihood of pregnancy termination decreased. Women who used contraceptives had a 24% higher likelihood of pregnancy termination than those who refrained from using them. Cohabiting women had a 57% higher chance of pregnancy termination. Working women had 15% higher odds than unemployed women. Women who experienced domestic violence had a 14% higher odds of pregnancy termination than those who did not. Women from the Northern, Eastern, and North Central provinces had a lower likelihood of pregnancy termination compared to those from the Western province. Women in the urban sector were more likely to terminate their pregnancy than those in the estate sector. Further, women residing in households where indoor smoking was permitted had a 13% greater chance of ending their pregnancy compared to non-smoking households. The study highlights the importance of restructuring education related to health and well-being, family planning, and work-life balancing for both women and their partners, and developing and implementing or strengthening policies and laws related to mitigating pregnancy termination including domestic violence for women.

Pregnancy and working conditions in the hospital sector: a scoping review

The different areas and work environments in the hospital sector have a complex set of occupational risk factors that can negatively impact the health of pregnant workers. Illness among this workforce results in sick leave due to work-related diseases and pregnancy, with high absenteeism. The main objective of this study was to review the available literature on the gestational and occupational risks to which pregnant health workers are exposed, causes of absenteeism, and issues related to maternity protection and work in the hospital sector. The authors used online databases to identify papers published in English from 2015 to 2020, based on the PRISMA Extension for Scoping Reviews and three steps of Snowballing. The study reviewed 18 peer-reviewed scientific articles that address pregnancy, work, absenteeism, and maternity protection. Most studies used a quantitative approach (12) and cohort studies in particular (6). The distribution of articles by themes was as follows: pregnancy, health and safety at work (11); pregnancy, health conditions, and absenteeism (13); and work and maternity protection (10). Some inferences were possible from the themes raised. However, the results revealed a gap and the need for specific studies for healthcare workers in the hospital sector, focusing on maternity. This review contributes to more in-depth studies on developing programs, actions, and legislation to protect maternity in hospital working environments.

COVID-19 Vaccine Acceptance of Pregnant and Lactating Women (PLW) in Czechia: An Analytical Cross-Sectional Study

Pregnant and lactating women (PLW) represent a particular population subset with increased susceptibility for COVID-19 morbidity and mortality, even though the evidence about the safety and efficacy of COVID-19 vaccines was delayed due to their initial exclusion from development trials. This unclear situation could have led to increased COVID-19 vaccine hesitancy levels among PLW; therefore, this study aimed to evaluate the attitudes of Czech PLW towards COVID-19 vaccines and the determinants of their attitudes. An analytical cross-sectional survey-based study was carried out in the University Hospital Brno (South Moravia, Czechia) between August and October 2021. The study utilised a self-administered questionnaire (SAQ) adapted from previous instruments used for the same purpose. The SAQ included closed-ended items covering demographic characteristics, clinical and obstetric characteristics, attitudes towards COVID-19 vaccination, and potential psychosocial predictors of vaccine acceptance. Out of the 362 included participants, 278 were pregnant (PW) and 84 were lactating women (LW). The overall COVID-19 vaccine acceptance (immediate and delayed) level was substantially high (70.2%), with a significant difference between PW (76.6%) and LW (48.8%). Out of the 70.2% who agreed to receive the vaccine, 3.6% indicated immediate acceptance, and 66.6% indicated delayed acceptance. Only 13.3% of the participants indicated their acceptance of their physician's vaccination recommendation during pregnancy or while lactating, and 62.2% were against it. Our results agreed with the recent studies that revealed that PW tended to have a high level of COVID-19 vaccine acceptance, and they were also inclined to resist professional recommendations because they predominantly preferred to delay their vaccination. The pregnancy trimester, education level, employment status, and previous live births were significant determinants for COVID-19 vaccine acceptance. The most commonly preferred vaccine type was mRNA-based vaccines, followed by viral vector-based and inactivated virus vaccines. The first top priority of PLW was vaccine safety for their children, followed by vaccine safety for the PLW and vaccine effectiveness. Regarding psychosocial predictors, media/social media, trust in the government, the pharmaceutical industry, and healthcare professionals, partners, and a positive risk-benefit ratio were significant promoters for COVID-19 vaccine acceptance. Findings from this study suggest that promotional interventions targeting PLW should use web platforms and focus on vaccine safety evidence, the expected benefits of vaccines and potential harms of the infection.

Epidemiology of low birth weight in Iran: A systematic review and meta-analysis

Introduction

Low birth weight (LBW) is an important general health indicator. The present study was conducted to evaluate the prevalence and risk factors of LBW in Iran.

Method

This meta-analysis was reported based on the PRISMA guidelines. All stages were independently performed by two authors. This review is registered with PROSPERO (CRD42020163446). We searched epidemiological studies at international databases of Scopus, Embase, Science Direct, PubMed/Medline, CINAHL, EBSCO, Cochrane Library, Web of Science, and Google Scholar search engine, as well as Iranian databases of SID, IranDoc, Iranian National Library, Barakat Knowledge Network System, RICST and Magiran using MeSH keywords without time limit until 2019. After selecting the studies, applying the inclusion and exclusion criteria, data extraction and qualitative assessment, the data were analyzed based on random effects model using Comprehensive Meta-Analysis Software version 2. P < 0.05 was considered significant.

Results

The prevalence of LBW in Iran was 7.95% (95% confidence interval [CI]: 7.36-8.58) in 62 studies with a sample size of 301,839 newborns. The prevalence of LBW in girls and boys was 8.41% (95%CI: 7.47-9.45) and 6.67% (95%CI: 5.86-7.59), respectively. The girls-to-boys odds ratio of LBW was 1.25 (95%CI: 1.13-1.39, P < 0.001) very LBW and extremely LBW prevalence was estimated to be 0.61% (95%CI: 0.40-0.93) and 0.29% (95% CI: 0.18-0.45), respectively. The risk factors for LBW were age of >35 versus [vs.] ≤35 (P = 0.024), age of <18 vs. ≥18 (P < 0.001), education of middle school and lower vs. high school and higher (P < 0.001), weight under 50 kg (P = 0.001), employed vs. housekeeper (P < 0.001), inadequate prenatal care (P = 0.046), interval with previous pregnancy <2 vs. >2 (P < 0.001), prematurity (P < 0.001), history of LBW (P < 0.001), multiple birth (P < 0.001), abortion (P < 0.001), vaginal bleeding (P < 0.001), hypertension (P = 0.001) and preeclampsia (P < 0.001).

Conclusion

The results of this meta-analysis showed that LBW is prevalent in Iran. This study can be a national database for LBW that would be of interest to Iranian health policy-makers and planners.

Low birth weight among term newborns in Wolaita Sodo town, South Ethiopia: a facility based cross-sectional study

Background

In low income countries, many low birth weight newborns often miss the chance for survival sooner or later. Others who survive would also face increased risks in later life. Though not adequately documented in Ethiopia, maternal factors pose the main risk. This study was aimed to estimate the proportion of low birth weight among term singletons without congenital malformations and factors associated with it in Wolaita Sodo town in South Ethiopia.

Methods

We did a facility based survey involving 432 postpartum women with their term newborns. Data was collected through face to face interview from March to April in 2016. The outcome measure was newborn birth weight. Bivariate logistic regression was applied to look for crude associations. Multivariate logistic regression analysis was done to adjust for potential confounders to identify independent predictors. Adjusted Odds Ratio (AOR) and 95% confidence intervals (CI), and statistical significance at P < 0.05 were reported.

Results

The proportion of term low birth weight was 8.1% in the study area. Women who had less education (AOR = 6.23; 95% CI = 1.68, 23.1), house wives (AOR = 5.85; 95% CI = 1.40, 24.3) and not frequently consuming fruits during pregnancy (AOR 11.3; 95% CI = 1.98, 64.9) had a higher risk of having term low birth weight newborns. We documented a lesser odds of those from rural settings to have low birth weight newborns as compared to their counter urban equivalents (AOR = 0.06; 95% CI = 0.006, 0.6).

Conclusions

Dietary counselling to pregnant mothers specific diet and nutrition including fruit diets in particular might contribute to reduce the risk of term low birth weight. Better education might have enabled women to prefer diets and their job engagements might also have capacitated them to decide on dietary preferences.

Electronic supplementary material

The online version of this article (10.1186/s12884-018-1789-y) contains supplementary material, which is available to authorized users.

Investigating the Prevalence of Preterm Birth in Iranian Population: A Systematic Review and Meta-Analysis

Introduction: Despite medical advances, preterm delivery remains a global problem in developed and developing countries. The present study was aimed at conducting a systematic review and meta-analysis of studies on the prevalence of preterm delivery in Iran.

Methods: This study was carried out on studies conducted in Iran by searching databases of SID, Magiran, Irandoc, MEDLIB, Iranmedex, PubMed, Web of science, Google Scholar and Scopus. The search was conducted using advanced search and keywords of preterm delivery and equivalents of it in Mesh and their Farsi’s Synonymous in all articles from 2000-2016.After extracting the data, the data were combined using a random model. Heterogeneity of the studies was assessed using Q test I2 index and the data were analyzed using STATA Ver.11 software.

Results: The total number of samples in this study was 41773. In 19 reviewed articles, the overall prevalence of preterm delivery, based on the random effects model, was estimated to be a total of 10% (95% CI, 9-12). The lowest prevalence of preterm labor was 5.4% in Bam and the highest prevalence was 19.85% in Tehran. There was no significant difference between the prevalence of preterm delivery compared to year of study and sample size.

Conclusion: This study reviewed the findings of previous studies and showed that preterm delivery is a relatively prevalent problem in Iran. Therefore, adopting appropriate interventions in many cases including life skills training, self-care and increasing pregnancy care to reduce these consequences and their following complications in high risk patients seem necessary.

Sick leave and medication use in pregnancy: a European web-based study

BACKGROUND AND OBJECTIVE

A comparison of sick leave in pregnancy between countries is difficult as most studies have been conducted in single countries in Scandinavia. The objective of this study was to explore patterns of and reasons for sick leave during pregnancy on a multinational level, focusing on medication use but also differences in sick leave policies.

DESIGN AND SETTING

Cross-sectional, web-based study in 12 European countries from October 2011 to February 2012. Data were collected via an electronic questionnaire.

PARTICIPANTS

Pregnant women and mothers of children under the age of 1 year.

PRIMARY OUTCOME MEASURE

Sick leave prevalence in pregnancy.

RESULTS

Of 6686 women included, 3385 (50.6%) had been on sick leave during pregnancy. The rates of sick leave varied across countries, ranging from 31.7%-34.8% in Sweden and the UK to 62.4%-71.3% in Norway, Serbia, Croatia and Poland. The most common reasons for being on sick leave were pregnancy complications (26.5%); pain in the neck, back or pelvic girdle (16.2%); and nausea and vomiting (NVP, 16.0%). Women using medications for acute illnesses were more likely to be on sick leave than their non-medicated counterparts, while an opposite trend was observed for women with chronic disorders, where non-medicated women were more likely to be on sick leave. Women from countries with 'low' sick leave policies were less likely to have extensions of sick leaves compared with women from countries with 'medium' policies (adjusted OR 0.63, 95% CI 0.49 to 0.82).

CONCLUSION

The rates of sick leave in pregnancy vary greatly across European countries. Women using medications were more likely to be on sick leave, especially for acute illnesses. The differences in sick leave patterns across countries only partially reflected differences in sick leave policies, which implies that sick leave in pregnancy is also affected by other national differences.